A 24-year-old pregnant woman at 28 weeks gestation presents during a cholera outbreak with profuse rice-water diarrhoea and dehydration. Stool culture confirms Vibrio cholerae O1. In addition to aggressive rehydration, the appropriate antimicrobial choice is:

• A Single dose doxycycline 300 mg
• B Co-trimoxazole for 5 days
• C Ciprofloxacin 500 mg twice daily for 3 days
• D Azithromycin ✓

Explanation

Azithromycin is the preferred antibiotic for cholera in pregnant women and young children because tetracyclines are contraindicated in pregnancy due to effects on fetal teeth and bone. Single dose doxycycline remains first line for non-pregnant adults, which makes it the tempting distractor here. Fluoroquinolones are avoided in pregnancy when alternatives exist, and co-trimoxazole is not a standard cholera drug.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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